Ophthalmologist Patricia McLaughlin doesn’t see eye-to-eye with ObamaCare: She’s been pushed onto a new insurance policy with a higher deductible, no out-of-network specialists and possibly fewer doctors.
Empire BlueCross/Blue Shield told the Upper East Side physician that it was forced to cancel the small- group coverage for her four-person office and write a new policy to abide by ObamaCare requirements.
“I’m getting less coverage than I had before,” McLaughlin said.
Empire raised the deductible from $2,000 to $2,500. The monthly premium per person came in $13 a month cheaper, or $470 month, and co-insurance payment remains 20 percent.
“I have to shell out another $500 for medication. It’s a big deal to a lot of people. The $500 is going to hit everyone, particularly patients who rely on chronic pain medication,” she said.
Empire is offering an “In Coverage Network Only” plan, eliminating the option of paying a higher deductible to go out of network.
“The reason is twofold: They weren’t selling [less than 2 percent of our members chose those plans], and the cost of out-of-network care in New York can be astronomical –driving up the cost of insurance and charges to consumers,” said Empire spokesperson Sally Kweskin.
McLaughlin suspects the list of available doctors and drugs will shrink.
She doesn’t know yet if her own doctors, including the internist she’s had for years, is in the network.
“I’m less happy right now,” McLaughlin said. “ These insurance companies are now using the ACA as the grand excuse to change the playing field from A to Z,” McLaughlin said.